Bladder Cancer and Upper Tract Urothelial Carcinoma – Current Treatment – Current Treatment: Physician Insights – Bladder Cancer and Upper Tract Urothelial Carcinoma (US)

Immune checkpoint inhibitors have revolutionized the treatment of bladder cancer and upper tract urothelial carcinoma (UTUC). Merck & Co.’s Keytruda and Bristol Myers Squibb’s Opdivo, once limited to locally advanced or metastatic disease, have moved to the resectable stages with the approval of Keytruda for high-risk non-muscle-invasive bladder cancer (NMIBC) in 2020 and Opdivo in the adjuvant setting for urothelial carcinoma in 2022. Merck KGaA / Pfizer’s Bavencio is entrenched as first-line maintenance treatment following platinum-containing chemotherapy. The combination of Keytruda plus Pfizer / Astella’s ADC Padcev is now available in the United States for the first-line treatment of locally advanced or metastatic disease, in addition to the drugs’ approval for later-line treatment as monotherapies. The approval of novel therapies (e.g., UroGen Pharma’s Jelmyto, a mitomycin intravesical solution for low-grade UTUC; Ferring’s viral vector therapy Adstiladrin for low-grade BCG-unresponsive NMIBC; Johnson & Johnson’s first-in-class FGFR inhibitor Balversa for previously treated metastatic patients with FGFR3 genetic alterations; Gilead Sciences’ ADC Trodelvy for later-line treatment) has greatly expanded physicians’ armamentarium and is reshaping the treatment paradigm.


  • How do drug-treatment rates vary across key patient populations and treatment lines?
  • What is the uptake of key immune checkpoint inhibitors in the United States across therapy lines? How are immune checkpoint inhibitors faring against older (e.g., platinum-based chemotherapy) and newer therapies (e.g., Balversa, Padcev, Trodelvy)?
  • Which clinical factors drive the prescribing of a first-line therapy (e.g., chemotherapy plus Bavencio maintenance therapy, Padcev plus Keytruda)? How are treatment lines strategized in locally advanced or metastatic disease?
  • What are the main drivers of and obstacles to treatment with key drugs for unresectable locally advanced or metastatic urothelial carcinomas (i.e., bladder and/or upper tract)?


Current Treatment: Physician Insights provides physician insights ontreatment dynamics, prescribing behavior, and drivers of brand useso that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

Markets covered: United States

Primary research: Survey of 100 medical oncologists and urologists in the United States fielded in April 2024.

Key drugs: Adstiladrin, Balversa, Bavencio, Jelmyto, Keytruda, Opdivo, Padcev, Trodelvy

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